Patil R.B.,Snmedical CollegeIndian Journal of Public Health Research and Development | Year: 2013

Pregnancy is a unique time in women's life accompanied by various physiologic, anatomic and hormonal changes in the body. The mouth is obvious portal of entry to the body and oral health reflects and influences general health and well being. Maternal oral health has significant implications for birth outcomes and infant oral health. Oral health promotion should include education of women and their health care providers ways to prevent oral disease from occurring, and referral for dental services when disease has occurred. This article discusses the oral changes during pregnancy and general considerations in care of pregnant patients.

There has been a significant increase in the number of reports of mucosal and systemic infections caused by Candida spp. in recent years. Despite the increase in the infection rates by Candida spp., therapeutic options for their treatment are relatively limited. In the recent years, there has been a marked increase in the incidence of treatment failures in candidosis patients receiving long term therapy, which poses a serious problem in the treatment of infections caused by Candida spp.

Joubert's syndrome is a rare cause of hypotonia and developmental delay in infancy and childhood [1]. Radiologically, the syndrome is characterized by malformations of the hind brain in the form of 'Molar tooth sign' and enlargement of the fourth ventricle with a bat wing configuration.

Objective: This study was an evaluation of the pattern of presentation, the outcome and the efficacy of Prazosin in scorpion sting envenomation at a tertiary care hospital in Bagalkot, India. Methods: A total of 240 consecutive children were prospectively studied. The data included demographics, the time of presentation to the hospital, the clinical features, and the premedication which was given before the arrival of the subjects at the hospital, response to the oral Prazosin and the hospital outcome. Results: Local pain, sweating and peripheral circulatory failure were the common clinical presentations. Complications like acutepulmonary oedema, myocarditis, shock and encephalopathy were also seen. These were treated with a combination of Prazosin with either inotropes or vasodilators. Mortality was seen in 18 (7.5%) children. The usage of antihistaminics and steroids in these children led to higher mortality. Oral Prazosin, a postsynaptic alpha -1 blocker, is a highly effective drug for scorpion sting envenomation. Conclusion: Scorpion sting envenomation is an acute life threatening emergency and an early presentation to the hospital and an early intervention with Prazosin can hasten the recovery in the scorpion sting victim.

Context: Enterococci are one of leading causes of nosocomial and community acquired infections and in recent years, they have become increasingly resistant to a wide range of antimicrobial agents. Aim: The present study was done to determine the species distribution and antimicrobial resistance pattern of enterococcal isolates. Material and Methods: 120 enterococcal isolates from different clinical samples were included in the study. They were identified by the standard microbiological methods and their antimicrobial susceptility was done by the Kirby-Bauer disc diffusion method. Vancomycin resistance was detected by the disc diffusion method and the agar dilution method and MIC testing was done by the macrobroth dilution method. High level aminoglycoside resistance (HLAR) was detected as per the CLSI guidelines. Results: E. faecium was the predominant species (47.50%) which was detected, followed by E.faecalis (44.16%) and others. E. faecium strains displayed a higher degree of drug resistance. The E.gallinarum species expressed low level vancomycin resistance, which was not detected by the disc diffusion method. More than 70% resistance was seen for ampicillin, erythromycin and tetracycline. 9(7.5%) isolates were found to be resistant to vancomycin. 5(4.16%) isolates were resistant to teicoplanin. All the isolates were susceptible to linezolid. HLAR was seen in 73(47.18%) isolates. Conclusion: E.faecium is now emerging as the predominant enterococcal species which causes infections and most of the enterococcal isolates (>77%) are multidrug resistant. Vancomycin resistance and HLAR in enterococci are rising rapidly. This study emphasizes the need for routinely carrying out a detailed speciation and antibiotic susceptibility testing of the enterococcal isolates in the bacteriology laboratory.

Background: Advance in mechanization and acceleration of travel have been accompanied by increase in number and severity of fractures and those of tibial plateau are no exception. Being one of the major weight bearing joints of the body, fractures around it are of paramount importance. The study was aimed to identify the role of surgical treatment of tibial plateau fractures, its functional outcome and complications. Methods: Thirty-two cases of tibial plateau fractures treated by various modalities were studied from Jan 2004 to Dec 2005 at Bapuji Hospital and Chigateri General Hospital, Davangere and followed for minimum period of 6 months. Results: The selected patients evaluated thoroughly: clinically and radiologically, were taken for surgery, after the relevant lab investigations. The indicated fractures were treated as per the SCHATZKER'S types accordingly with CRIF, with percutaneous cannulated cancellous screws, ORIF with buttress plate with or without bone grafting, external fixator. Early range of motion started soon after the surgery. No weight bearing upto 6-8 weeks. The full weight bearing deferred until 12 weeks or complete fracture union. Immobilization in insecurily fixed fractures continued for 3-6 weeks by POP cast. The knee range of motion was excellent to very good, gait and weight bearing after complete union was satisfactory. redepression in 1 case, malunion in 2 cases, knee stiffness in 3, wound dehiscence in 2 cases and non-union in none of our cases. Conclusion: Surgical management of tibial plateau fractures will give excellent anatomical reduction and rigid fixation to restore articular congruity, fascilitate early motion and reducing post-traumatic OA and hence to achieve optimal knee function.

Burn injuries due to attempted suicide and homicide are one of the leading causes of death and disability globally. In view of the above, this study was done with the objectives to elucidate epidemiological and outcome characteristics of alleged suicidal and homicidal burn injuries admitted in two tertiary care hospitals in South India. The present cross sectional study of all suicidal and homicidal burn injuries admitted in two tertiary care hospitals of Belgaum city during the study period from April 2004 to March 2005 were included after informed consent from the patients themselves or from close family members. Out of the total cases, 35(60.34%) were suicidal and 23(39.66%) were homicidal. Females contributed to 21(60%) of the suicidal and 17(73.91%) of the homicidal cases. Sixty percent (60%) of attempted suicidal burn injuries and 34.78% of homicidal victims had TBSA more than 80% and was found to be statistically significant In suicidal injuries, mortality was 81.80% and in homicidal cases it was 52.17%.

The anterior nares is the most frequent carriage site for Staphylococcus aureus. Methicillin resistant S.aureus (MRSA) are now the major hospital acquired pathogens worldwide. To know the prevalence of nasal carriage of S.aureus and MRSA among health care workers (HCWs) and to compare cefoxitin and oxacillin disc diffusion methods in detecting MRSA. Study was conducted on 102 HCWs of a tertiary care hospital consisting of 12 laboratory technicians, 37 staff nurses and 53 nursing students. Samples were collected from anterior nares using sterile cotton swab soaked in sterile saline. Swabs were processed without delay. S.aureus were identified by standard microbiological techniques. Detection of MRSA was done by cefoxitin and oxacillin disc diffusion method according CLSI 2011 guidelines. Highest S.aureus and MRSA carriage of 54.05% and 45.94% respectively was seen in staff nurses. S.aureus and MRSA carriage was 41.66% and 33.33% in laboratory technicians and 41.50% and 22.64% respectively in nursing students. Cefoxitin detected 33 and oxacillin detected 30 MRSA. Prevalence of nasal carriage of S.aureus and MRSA is very high in HCWs. Cefoxitin disc is superior to oxacillin disc in detecting MRSA. Continuous surveillance, decolonization of carriers and improvement of hygiene standards in hospital should be adopted to break the transmission of MRSA.

Background: Intra-abdominal masses always remain as an enigma in surgical practice. A documentary evidence of the nature of the pathology before the institution of therapy and for the prognosis is mandatory. FNAC is a substitute for surgical procedures like diagnostic laparotomy. Aims: To assess the utility of FNAC in the diagnosis of intraabdominal lesions. Objectives: To study the cytomorphological features, age and sex distribution of intra-abdominal lesions and to categorize them organwise and as inflammatory, benign and malignant lesions. To classify the malignant lesions according to their cell type. To evaluate the sensitivity, specificity and diagnostic accuracy. Materials and Methods: The study included 245 intra-abdominal lesions which were detected clinically or radiologically. The lesions were divided clinically into palpable and non-palpable lumps. USG or CT were used for all the non-palpable lesions and for a few palpable lesions and direct in selected palpable lesions. Giemsa's and Papanicolaou's stains were used. Results: The mean age was 45.16 years, with M:F of 1:1.3. The diagnostic yield was 92.1% in USG guided, 100% in CT guided and 95% in direct aspiration. There were 148 (60.3%) malignant, 55 (22.4%) benign, 25 (10.2%) inflammatory and one (0.6%) suspicious lesions and 16 (6.5%) unsatisfactory smears. The liver and the ovary were the most common sites. Adenocarcinomas and hepatocellular carcinomas were the most common malignant lesions. This study showed 94.1% sensitivity, 100% specificity, 100% positive predictive value, 92.3% negative predictive value and 96.5% diagnostic accuracy. Conclusion: Intra-abdominal FNA is a simple, economical and a safe procedure with high sensitivity, specificity and diagnostic accuracy and it can be utilized as a pre-operative procedure for the management of intra-abdominal lesions.

Epidermoid and dermoid cysts represent less than 0.01 % of all the oral cavity cysts. Most often, they are located in the submental region. Most of the patients present with a painless slow growing lump. Imaging is used to know the contents of the lesion and the plane of the swelling, so that a surgical approach can be decided. Here, we present a case of an epidermoid cyst in the neck, which was diagnosed by ultrasonography and magnetic resonance imaging and confirmed by histopathological examination.